This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy. In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots. A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search. A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors. Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives. To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.

Introduction: Smokers have a higher chance of developing peri-implant diseases and are therefore considered an at-risk population. Our aim was to compare peri-implant characteristics in users of electronic cigarettes (EC), waterpipes (WP), cigarettes (CS), smokeless tobacco (ST), and nonsmokers (nonusers of any nicotine and tobacco product; NS). Aims and Methods: A systematic search of four electronic databases (PubMed, EMBASE, Web of Science, and CENTRAL) was performed until April 2023, restricted to English language. Thirty-nine observational studies were included in the qualitative synthesis, of which 32 studies were included in a Bayesian network meta-analysis. Using a predesigned form, two researchers independently collected data about marginal bone loss (MBL), probing pocket depth (PPD), plaque index, bleeding on probing, modified plaque index, probing pocket depth > 4 mm (PPD > 4), gingival index, peri-implant sulcular fluid volume, and TNF-α and IL-1β levels. QUIPS and CINeMA were used to evaluate the risk of bias and certainty of evidence. Results: Nonsmokers had the smallest MBL. Most nicotine-containing product users had significantly higher MBL (CS, mean difference [MD]: 1.34 credible interval [CrI]: 0.85, 1.79; WP, MD: 1.58 CrI: 0.84, 2.35; ST, MD: 2.53, CrI: 1.20, 3.87) than NS. Electronic cigarettes did not show significant difference compared to NS (MD: 0.52 CrI: −0.33, 1.36). In secondary outcomes, NS were ranked in first place. Subset analysis based on smoking habit, implant duration, and maintenance control revealed no differences in ranking probability. Conclusions: Most nicotine-containing product users presented worse peri-implant parameters compared to NS, while EC users did not show significant differences to NS in many outcomes. Implications: Alternative nicotine-containing products are gaining popularity and are often considered less harmful by the general public compared to traditional cigarettes. This is the first network meta-analysis comparing users of four nicotine-containing products and NS. This study shows that CS, WP, and ST have a detrimental effect on the overall health of peri-implant tissues. EC users also presented inferior parameters compared to NS; however, the difference was not significant in many outcomes. It is essential to educate patients who are using nicotine-containing products, and to provide proper maintenance and appropriate cessation support. Well-designed multiarmed studies are needed for direct comparison of different products, including heated tobacco products. Greater transparency of confounding factors is needed regarding smoking habit and oral hygiene.

Objective: This study aimed to investigate the accuracy of conventional and digital impression‐making and cast‐fabrication using coded healing abutments on an edentulous mandibular model under in vitro conditions.Materials and Methods: Our study investigated the accuracy of the On1 Concept (Nobel Biocare; Kloten, Switzerland) coded healing abutment system using conventional and digital workflows. The Conical Connection (CC) system (Nobel Biocare; Kloten, Switzerland) was used as the control group in both workflows. 10–10 open‐tray impressions and intraoral scans were made from the reference model with each system. Models built from intraoral scans were additively fabricated, and open‐tray impressions were poured with type‐4 dental stone. The prepared models were digitized using a desktop scanner with an accuracy of 4 μm (E4, 3Shape; Copenhagen, Denmark) and superimposed on the reference scan. Four linear distances and root mean square (RMS) deviations were measured using metrology software.Results: Five dimensions were measured using signed and absolute deviations, resulting in nine outcomes. RMS and diagonal deviations provided the most insight into overall model deviations. Mean RMS deviations were: 58.30 (14.95) μm for CC_conv, 47.66 (13.04) μm for On1_conv, 204.97 (37.40) μm for CC_dig, and 136.64 (13.49) μm for On1_dig. Significant differences were found between On1_conv vs. CC_dig, On1_conv vs. On1_dig, and CC_conv vs. CC_dig. Mean linear deviations between the molar positions were: 24.49 (58.20) μm for CC_conv, 87.46 (106.70) μm for On1_conv, −104.76 (125.83) μm for CC_dig, and 140.64 (190.56) μm for On1_dig. Significant differences were observed between On1_conv vs. CC_dig and CC_dig vs. On1_dig.Conclusions: Based on the RMS deviations, the conventional method is significantly more accurate at both implant and platform levels in the case of an in vitro edentulous lower jaw model. The RMS deviations of the implant analogs are smaller on the platform level with both conventional and digital methods.

Objectives: Digital impression-taking techniques are widely used due to their many advantages. However, the accuracy of intraoral scanning in full-arch cases remains a matter of debate. The reliability of different digital implant impression techniques remains questionable in completely edentulous, full-arch cases. This review investigated the accuracy of digital implant impression techniques for full-arch use. Methods: Our study protocol was registered in the PROSPERO database (CRD42023393091). Data reporting was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, by the Cochrane Handbook. Comparative in vitro studies matching the PICO framework were included. A systematic search was conducted in four databases: PubMed (MEDLINE), EMBASE, Web of Science and the Cochrane Library (Cochrane Central Register of Controlled Trials [CENTRAL]). Results: Thirty-four papers were included in analyzing trueness and precision of root mean square (RMS) deviations. No significant differences were observed between test groups. The overall RMS trueness deviation was 53.36 μm [18.44; 88.28] in the extraoral stereophotogrammetry group, 73.88 μm [36.68; 111.09] in the conventional impression group, 99.54 μm [56.22; 142.86] in the IOS plain group, 104.88 μm [36.86; 172.90] in the IOS scanaid group, and 65.58 μm [5.24; 125.92] in the IOS splinted group. Substantial heterogeneity was observed across studies (I² ≈ 100%) Conclusions: In case of completely edentulous jaws restored with four to eight implants, digital techniques showed comparable accuracy to the conventional method with no statistically significant differences detected.

Purpose: Additive cast-fabrication has yet to be used as commonly in implant prosthodontics as conventional methods. This review aimed to investigate the accuracy of additive cast-fabrication in implant prosthodontics.Study selection: The study protocol was registered in the PROSPERO database (CRD42022374972). Reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, following the Cochrane Handbook. Two-arm interventional studies that matched the PICO were included (Population: dental typodonts with implants, Intervention: additive cast-fabrication, Comparator: conventional cast-fabrication, Outcome: positional deviations). A systematic search was conducted in three databases: PubMed (MEDLINE), EMBASE, and the Cochrane Library (CENTRAL).Results: Seven papers were included in the analysis of horizontal, vertical, and root mean square (RMS) deviations. No significant differences were observed between groups. The overall vertical mean deviation of the intervention group was -4.15 µm [-24.88; 16.57], and the pooled mean absolute deviation was 22.43 µm [8.33; 36.54]. In the control group, these values were 19.67 µm [-32.71; 72.04] and 24.62 µm [0.00; 59.42], respectively. The overall horizontal mean deviation in the intervention group was 21.29 µm [-77.10; 119.68], and the pooled mean absolute deviation was 26.96 µm [0.00; 70.81]. In the control group, the overall mean was 1.45 µm [-32.26; 35.15] and the pooled mean absolute deviation was 25.05 µm [9.08; 41.01]. The mean RMS was only slightly larger in the intervention group, with the value of 14.74 µm [-107.26; 136.74].Conclusions: Additive cast-fabrication is as accurate as the conventional method for the position of implant analogs.

Aim: This systematic review and meta‐analysis aimed to compare soft and hard tissue outcomes of applying anatomic healing abutments (AHA) and provisional restorations (PR) versus cylindrical healing abutments (CHA) on immediately placed single implants. Materials and Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched on September 8, 2025, for two‐armed studies comparing AHA/PR to CHA on immediate single‐tooth implants. Outcomes included implant survival (IS), marginal bone loss (MBL), pink esthetic score (PES), patient satisfaction, as well as buccal bone and mucosal changes. Random‐effects meta‐analyses were performed. Results: Twenty studies were included; 12 contributed to quantitative synthesis, showing no difference in IS (over 99% in all groups), MBL, or patient satisfaction. Pooled analysis of seven studies (340 implants) showed higher PES with AHA and PR than CHA group at 1 year (MD: 2.54; 95% CI: 1.12–3.96). Descriptive evidence suggested a trend toward improved horizontal tissue preservation with individualized healing. Conclusion: Within the limitations of this study, PR significantly improved PES without compromising IS or MBL. Their use may be beneficial, especially in the esthetic region, but further studies are needed to investigate their cost‐effectiveness and long‐term effect, especially on horizontal tissue changes. Clinical Implications: Anatomically shaped healing abutments and provisional restorations provide higher pink esthetics around immediately placed single implants, which is especially relevant for restorations in the anterior region.